Katsutoshi Sugimoto, Presenter: Nothing to Disclose

Junji Shiraishi, Abstract Co-Author: Nothing to Disclose

Fuminori Moriyasu MD, PhD, Abstract Co-Author: Nothing to Disclose

Kunio Doi PhD, Abstract Co-Author: Shareholder, Hologic, Inc License agreement, Hologic, Inc License agreement, Deus Technologies, LLC License agreement, Riverain Medical License agreement, Mitsubishi Corporation License agreement, MEDIAN Technologies License agreement, General Electric Company License agreement, Toshiba Corporation Research support, Deus Technologies, LLC Research support, DuPont Research support, Elbit Medical Imaging Ltd Research support, Fuji Photo Film Co, Ltd Research support, General Electric Company Research support, Hitachi, Ltd Research support, Eastman Kodak Company Research support, Konica Minolta Group Research support, Mitaya Manufacturing Co, Ltd Research support, Mitsubishi Corporation Research support, Koninklijke Philips Electronics NV Research support, Hologic, Inc Research support, Riverain Medical Research support, Seiko Corporation Research support, Siemens AG Research support, 3M Company Research support, Toshiba Corporation

To evaluate the clinical utility of a computer-aided diagnosis (CAD) scheme for the improvement of diagnostic performance of radiologists for differentiation of focal liver lesions (FLLs) on Sonazoid-enhanced ultrasonography (CEUS).

Informed consent and institutional review board approval were obtained. Our data set contained 107 FLLs from 106 cases, consisted of 27 metastases, 27 hemangiomas, and 53 hepatocellular carcinomas (HCCs): 17 well-differentiated, 26 moderately differentiated, and 10 poorly differentiated. Pathologies of all cases except for hemangiomas were determined based on biopsy or surgical specimens. The CEUS images were obtained with use of AplioXG (Toshiba, Japan), including B-mode, vascular imaging with micro-flow imaging (defined as <60 seconds after injection), and Kupffer phase (defined as 10 minutes after injection). The CAD displayed vascular imaging as movie files, B-mode and Kupffer images as static images. The observer study was conducted with seven radiologists with experience in CEUS of the liver, all of whom were first asked to give confidence ratings regarding benign or malignant; second, if malignant, whether metastasis or HCCs; finally to select one of 5 classifications matched to the unknown FLL. Each radiologist read cases first without CAD and immediately thereafter with CAD. Observers’ rating data were analyzed with the multi-reader multi-case receiver operating characteristic (ROC) analysis.

The overall sensitivity of our CAD for differentiation of 5 types of FLLs included in the database was 76.6% (82/107). For all seven participants, as to benign vs. malignant, the mean area under the ROC curve (AUC) values were improved significantly from 0.861±0.068 without CAD to 0.942±0.045 with CAD (p<0.001). In addition, as to metastasis vs. HCC, the mean AUC values were also improved significantly from 0.707±0.09 to 0.776±0.075 by use of the CAD (p=0.035). The overall sensitivity of all observers was also improved from 52.6% to 66.5%.

The use of the CAD can significantly improve the diagnostic performance of radiologists for differential diagnosis of the FLLs on CEUS.

Computer-aided diagnosis (CAD) could be useful for diagnosing focal liver lesions (FLLs) on Sonazoid-enhanced US; thus, it would potentially improve radiologists’ accuracy for FLLs.

Sugimoto, K, Shiraishi, J, Moriyasu, F, Doi, K, Focal Liver Lesions on Sonazoid-enhanced US: Clinical Utility of Computer-aided Diagnosis for the Improvement of Radiologists’ Diagnostic Accuracy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005181.html